CIGUATERA FISH POISONING

Ciguatera fish poisoning is the most common foodborne illness related to fin fish consumption and is endemic throughout the Caribbean and In do-Pacific regions. The clinical picture is characterized by a variety of gastrointestinal, neurologic and, occasionally, cardiovascular sym ptoms. Patients with bradycardia and/or hypotension may require urgent care. Neurologic symptoms tend to be the most distinctive and endurin g and include sensory changes such as generalized pruritus, circumoral numbness and reversal of hot and cold sensation. Intravenous mannitol has evolved as a unique remedy for patients with acute poisoning, but management of chronic symptoms continues to be problematic. Though di fficult to implement, preventive strategies remain the best defense.